Relationship and prognostic value of the triglyceride-glucose index and optical coherence tomography-derived physiological index in patients with acute coronary syndrome

Abstract The optical flow ratio (OFR), derived from optical coherence tomography (OCT) images, serves as a physiological index, while the Triglyceride-Glucose Index (TyG) is an alternative measure of insulin resistance. Both indices are positively correlated with poor prognosis in patients with acut...

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Main Authors: Li Pan, Shiwan Lu, Qianhang Xia, Yi Deng, Junlin Wu, Shitao Luo, Chancui Deng, Ning Gu, Shuangya Yang, Guangtao Zhou, Xiaoling Fu, Ranzun Zhao, Zhenglong Wang, Yongchao Zhao, Bei Shi
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Language:English
Published: Nature Portfolio 2025-05-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-96991-8
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author Li Pan
Shiwan Lu
Qianhang Xia
Yi Deng
Junlin Wu
Shitao Luo
Chancui Deng
Ning Gu
Shuangya Yang
Guangtao Zhou
Xiaoling Fu
Ranzun Zhao
Zhenglong Wang
Yongchao Zhao
Bei Shi
author_facet Li Pan
Shiwan Lu
Qianhang Xia
Yi Deng
Junlin Wu
Shitao Luo
Chancui Deng
Ning Gu
Shuangya Yang
Guangtao Zhou
Xiaoling Fu
Ranzun Zhao
Zhenglong Wang
Yongchao Zhao
Bei Shi
author_sort Li Pan
collection DOAJ
description Abstract The optical flow ratio (OFR), derived from optical coherence tomography (OCT) images, serves as a physiological index, while the Triglyceride-Glucose Index (TyG) is an alternative measure of insulin resistance. Both indices are positively correlated with poor prognosis in patients with acute coronary syndrome (ACS), but the relationship between the TyG index, OFR, and their prognostic value remains unclear. We included ACS patients who underwent OCT between January 1, 2021, and March 31, 2023. The TyG index was calculated as Ln[fasting triglycerides (mg/dL) × fasting blood glucose (mg/dL)/2]. Patients were grouped into three categories (T1, T2, and T3) based on TyG tertiles. The primary endpoint was major adverse cardiovascular events (MACE). In our analysis, the T3 group showed a significantly higher incidence of MACE (P < 0.05), with a progressive decrease in vessel-level OFR observed as the TyG index increased, demonstrating a linear correlation (r = − 0.0146, P < 0.001). The restricted cubic splines (RCS) model revealed a nonlinear relationship between the TyG index and the likelihood of MACE (P for nonlinear < 0.021). Additionally, the cumulative incidence of MACE was significantly higher in patients with a higher TyG index (all Log-rank P < 0.001).These findings suggest a nonlinear relationship between the TyG index and MACE, and a linear association between the TyG index and vessel-level OFR. The combination of the TyG index and OFR significantly improved discriminatory ability (c-index: 0.720 vs. 0.757; P < 0.001) and reclassification ability (net reclassification index [NRI]: 0.373; integrated discrimination improvement [IDI]: 0.031; P < 0.0001) for predicting MACE compared to vessel-level OFR alone. This combination effectively identifies high-risk ACS patients.
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spelling doaj-art-7545a71ed1884ee4b51d2a7cc543e5e52025-08-20T01:51:27ZengNature PortfolioScientific Reports2045-23222025-05-0115112210.1038/s41598-025-96991-8Relationship and prognostic value of the triglyceride-glucose index and optical coherence tomography-derived physiological index in patients with acute coronary syndromeLi Pan0Shiwan Lu1Qianhang Xia2Yi Deng3Junlin Wu4Shitao Luo5Chancui Deng6Ning Gu7Shuangya Yang8Guangtao Zhou9Xiaoling Fu10Ranzun Zhao11Zhenglong Wang12Yongchao Zhao13Bei Shi14Department of Cardiology, Affiliated Hospital of Zunyi Medical UniversityDepartment of Cardiology, Affiliated Hospital of Zunyi Medical UniversityDepartment of Cardiology, The Third Affiliated Hospital of Zunyi Medical UniversityDepartment of Cardiology, Affiliated Hospital of Zunyi Medical UniversityDepartment of Cardiology, Affiliated Hospital of Zunyi Medical UniversityDepartment of Cardiology, Affiliated Hospital of Zunyi Medical UniversityDepartment of Cardiology, Affiliated Hospital of Zunyi Medical UniversityDepartment of Cardiology, Affiliated Hospital of Zunyi Medical UniversityDepartment of Cardiology, Affiliated Hospital of Zunyi Medical UniversityDepartment of Cardiology, Affiliated Hospital of Zunyi Medical UniversityDepartment of Cardiology, Affiliated Hospital of Zunyi Medical UniversityDepartment of Cardiology, Affiliated Hospital of Zunyi Medical UniversityDepartment of Cardiology, The Third Affiliated Hospital of Zunyi Medical UniversityDepartment of Cardiology, Affiliated Hospital of Zunyi Medical UniversityDepartment of Cardiology, Affiliated Hospital of Zunyi Medical UniversityAbstract The optical flow ratio (OFR), derived from optical coherence tomography (OCT) images, serves as a physiological index, while the Triglyceride-Glucose Index (TyG) is an alternative measure of insulin resistance. Both indices are positively correlated with poor prognosis in patients with acute coronary syndrome (ACS), but the relationship between the TyG index, OFR, and their prognostic value remains unclear. We included ACS patients who underwent OCT between January 1, 2021, and March 31, 2023. The TyG index was calculated as Ln[fasting triglycerides (mg/dL) × fasting blood glucose (mg/dL)/2]. Patients were grouped into three categories (T1, T2, and T3) based on TyG tertiles. The primary endpoint was major adverse cardiovascular events (MACE). In our analysis, the T3 group showed a significantly higher incidence of MACE (P < 0.05), with a progressive decrease in vessel-level OFR observed as the TyG index increased, demonstrating a linear correlation (r = − 0.0146, P < 0.001). The restricted cubic splines (RCS) model revealed a nonlinear relationship between the TyG index and the likelihood of MACE (P for nonlinear < 0.021). Additionally, the cumulative incidence of MACE was significantly higher in patients with a higher TyG index (all Log-rank P < 0.001).These findings suggest a nonlinear relationship between the TyG index and MACE, and a linear association between the TyG index and vessel-level OFR. The combination of the TyG index and OFR significantly improved discriminatory ability (c-index: 0.720 vs. 0.757; P < 0.001) and reclassification ability (net reclassification index [NRI]: 0.373; integrated discrimination improvement [IDI]: 0.031; P < 0.0001) for predicting MACE compared to vessel-level OFR alone. This combination effectively identifies high-risk ACS patients.https://doi.org/10.1038/s41598-025-96991-8Acute coronary syndromeInsulin resistanceOptical coherence tomographyIntracoronary imagingComputed physiology
spellingShingle Li Pan
Shiwan Lu
Qianhang Xia
Yi Deng
Junlin Wu
Shitao Luo
Chancui Deng
Ning Gu
Shuangya Yang
Guangtao Zhou
Xiaoling Fu
Ranzun Zhao
Zhenglong Wang
Yongchao Zhao
Bei Shi
Relationship and prognostic value of the triglyceride-glucose index and optical coherence tomography-derived physiological index in patients with acute coronary syndrome
Scientific Reports
Acute coronary syndrome
Insulin resistance
Optical coherence tomography
Intracoronary imaging
Computed physiology
title Relationship and prognostic value of the triglyceride-glucose index and optical coherence tomography-derived physiological index in patients with acute coronary syndrome
title_full Relationship and prognostic value of the triglyceride-glucose index and optical coherence tomography-derived physiological index in patients with acute coronary syndrome
title_fullStr Relationship and prognostic value of the triglyceride-glucose index and optical coherence tomography-derived physiological index in patients with acute coronary syndrome
title_full_unstemmed Relationship and prognostic value of the triglyceride-glucose index and optical coherence tomography-derived physiological index in patients with acute coronary syndrome
title_short Relationship and prognostic value of the triglyceride-glucose index and optical coherence tomography-derived physiological index in patients with acute coronary syndrome
title_sort relationship and prognostic value of the triglyceride glucose index and optical coherence tomography derived physiological index in patients with acute coronary syndrome
topic Acute coronary syndrome
Insulin resistance
Optical coherence tomography
Intracoronary imaging
Computed physiology
url https://doi.org/10.1038/s41598-025-96991-8
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